TY - JOUR
T1 - Third- or Later-line Therapy for Metastatic Colorectal Cancer
T2 - Reviewing Best Practice
AU - Bekaii-Saab, Tanios
AU - Kim, Richard
AU - Kim, Tae Won
AU - O'Connor, Juan Manuel
AU - Strickler, John H.
AU - Malka, David
AU - Sartore-Bianchi, Andrea
AU - Bi, Feng
AU - Yamaguchi, Kensei
AU - Yoshino, Takayuki
AU - Prager, Gerald W.
N1 - Funding Information:
T. Bekaii-Saab declares consulting fees from AbbVie, Merck, Silajen, Exelixis, and Armo; consultant for Bayer, Genentech, and Roche with fees received by his employer. R. Kim declares advisory board for Bayer and BMS, and speaker bureau for Taiho. T.W. Kim declares advisory board for Bayer Healthcare; and research grant from Merck Serono, AstraZeneca, Bayer. D. Malka declares consultancy, honoraria, and travel fees from Amgen, Bayer, Merck, Merck Serono, Roche, Sanofi, and Servier, and consultancy and honoraria from Shire and Halio Dx. J.M. O'Connor declares advisory board for Roche, MSD, Merck Serono, BMS, Eli Lilly, and Servier and research grants from Merck Serono and Bayer HealthCare. G.W. Prager declares advisory board for Bayer Healthcare, Servier, BMS, Roche, Merck Serono, Amgen, and Lilly. A. Sartore-Bianchi declares advisory board for Amgen, Bayer Healthcare, and Sanofi. J.H. Strickler declares advisory board for Bayer Healthcare, Amgen, AstraZeneca, Celgene, Genentech/Roche, and OncoMed; and research support from OncoMed (NCT02482441, NCT01647828), Seattle Genetics (NCT03043313, NCT02952989), Exelixis (NCT02008383), Roche/Genentech (NCT02715531, NCT02650713), Abbvie (NCT03234712, NCT03368859, NCT02565758), Gilead (NCT02545504), MedImmune (NCT02503774), Macrogenics (NCT02248805, Nektar (NCT03435640), Leap Therapeutics (NCT02013154) and Sanofi Genzyme (NCT01661972). K. Yamaguchi declares consulting/advisory role for Bristol-Myers Squibb, Japan, and Daiichi Sankyo; speakers’ bureau for Chugai Pharma, Merck Serono, Bristol-Myers Squibb, Japan, Takeda, Taiho Pharmaceutical, Lilly, Yakult Honsha, Ono Pharmaceutical, and Sanofi; research funding from MSD Oncology, Ono Pharmaceutical, Dainippon Sumitomo Pharma, Taiho Pharmaceutical, Daiichi Sankyo, Lilly, Gilead Sciences, and Yakult Honsha. T. Yoshino declares advisory board for Bayer Healthcare. Funding: The support for the preparation of this manuscript was provided by Bayer Healthcare. Medical writing support, including assisting authors with the development of the outline and initial draft, incorporation of comments, and preparation of tables and figures, was provided by Bernard Kerr, PGDipSci, CMPP, Melanie Jones, BSc, and Alison Scott, PhD, and editorial support, including fact checking, referencing, figure preparation, formatting, proofreading, and submission was provided by Ian Norton and Faye Gould, PhD, CMPP, all of Scion (London, UK), supported by Bayer Healthcare according to Good Publication Practice guidelines (http://annals.org/aim/fullarticle/2424869/good-publication-practice-communicating-company-sponsored-medical-research-gpp3). Bayer Healthcare was involved in the fact-checking of information provided in the manuscript. However, ultimate responsibility for opinions, conclusions, and data interpretation lies with the authors. Funding: The support for the preparation of this manuscript was provided by Bayer Healthcare.
Funding Information:
T. Bekaii-Saab declares consulting fees from AbbVie, Merck, Silajen, Exelixis, and Armo; consultant for Bayer, Genentech, and Roche with fees received by his employer. R. Kim declares advisory board for Bayer and BMS, and speaker bureau for Taiho. T.W. Kim declares advisory board for Bayer Healthcare; and research grant from Merck Serono , AstraZeneca , Bayer . D. Malka declares consultancy, honoraria, and travel fees from Amgen, Bayer, Merck, Merck Serono, Roche, Sanofi, and Servier, and consultancy and honoraria from Shire and Halio Dx. J.M. O’Connor declares advisory board for Roche, MSD, Merck Serono, BMS, Eli Lilly, and Servier and research grants from Merck Serono and Bayer HealthCare . G.W. Prager declares advisory board for Bayer Healthcare, Servier, BMS, Roche, Merck Serono, Amgen, and Lilly. A. Sartore-Bianchi declares advisory board for Amgen, Bayer Healthcare, and Sanofi. J.H. Strickler declares advisory board for Bayer Healthcare, Amgen, AstraZeneca, Celgene, Genentech/Roche, and OncoMed; and research support from OncoMed ( NCT02482441 , NCT01647828 ), Seattle Genetics ( NCT03043313 , NCT02952989 ), Exelixis ( NCT02008383 ), Roche/Genentech ( NCT02715531 , NCT02650713 ), Abbvie ( NCT03234712 , NCT03368859 , NCT02565758 ), Gilead ( NCT02545504 ), MedImmune ( NCT02503774 ), Macrogenics ( NCT02248805 , Nektar ( NCT03435640 ), Leap Therapeutics ( NCT02013154 ) and Sanofi Genzyme ( NCT01661972 ). K. Yamaguchi declares consulting/advisory role for Bristol-Myers Squibb, Japan, and Daiichi Sankyo; speakers’ bureau for Chugai Pharma, Merck Serono, Bristol-Myers Squibb, Japan, Takeda, Taiho Pharmaceutical, Lilly, Yakult Honsha, Ono Pharmaceutical, and Sanofi; research funding from MSD Oncology , Ono Pharmaceutical , Dainippon Sumitomo Pharma , Taiho Pharmaceutical , Daiichi Sankyo , Lilly , Gilead Sciences , and Yakult Honsha . T. Yoshino declares advisory board for Bayer Healthcare.
Funding Information:
T. Bekaii-Saab declares consulting fees from AbbVie, Merck, Silajen, Exelixis, and Armo; consultant for Bayer, Genentech, and Roche with fees received by his employer. R. Kim declares advisory board for Bayer and BMS, and speaker bureau for Taiho. T.W. Kim declares advisory board for Bayer Healthcare; and research grant from Merck Serono, AstraZeneca, Bayer. D. Malka declares consultancy, honoraria, and travel fees from Amgen, Bayer, Merck, Merck Serono, Roche, Sanofi, and Servier, and consultancy and honoraria from Shire and Halio Dx. J.M. O'Connor declares advisory board for Roche, MSD, Merck Serono, BMS, Eli Lilly, and Servier and research grants from Merck Serono and Bayer HealthCare. G.W. Prager declares advisory board for Bayer Healthcare, Servier, BMS, Roche, Merck Serono, Amgen, and Lilly. A. Sartore-Bianchi declares advisory board for Amgen, Bayer Healthcare, and Sanofi. J.H. Strickler declares advisory board for Bayer Healthcare, Amgen, AstraZeneca, Celgene, Genentech/Roche, and OncoMed; and research support from OncoMed (NCT02482441, NCT01647828), Seattle Genetics (NCT03043313, NCT02952989), Exelixis (NCT02008383), Roche/Genentech (NCT02715531, NCT02650713), Abbvie (NCT03234712, NCT03368859, NCT02565758), Gilead (NCT02545504), MedImmune (NCT02503774), Macrogenics (NCT02248805, Nektar (NCT03435640), Leap Therapeutics (NCT02013154) and Sanofi Genzyme (NCT01661972). K. Yamaguchi declares consulting/advisory role for Bristol-Myers Squibb, Japan, and Daiichi Sankyo; speakers’ bureau for Chugai Pharma, Merck Serono, Bristol-Myers Squibb, Japan, Takeda, Taiho Pharmaceutical, Lilly, Yakult Honsha, Ono Pharmaceutical, and Sanofi; research funding from MSD Oncology, Ono Pharmaceutical, Dainippon Sumitomo Pharma, Taiho Pharmaceutical, Daiichi Sankyo, Lilly, Gilead Sciences, and Yakult Honsha. T. Yoshino declares advisory board for Bayer Healthcare.
Publisher Copyright:
© 2018 The Authors
PY - 2019/3
Y1 - 2019/3
N2 - An increasing number of patients with metastatic colorectal cancer (mCRC) are able to receive 3 or more lines of therapy. Treatments in this setting can include regorafenib (an oral multikinase inhibitor), trifluridine/tipiracil hydrochloride (TAS-102), antibodies that target epidermal growth factor receptor for patients with RAS wild-type tumors (if no prior exposure), and, where approved, anti-programmed cell death protein 1 inhibitors for patients with microsatellite instability-high mCRC. Although guidelines describe the available treatment options, few insights are provided to guide selection and sequencing. In this article, we share expert opinion from diverse geographic regions, to offer guidance for best practice when selecting and managing third-line treatment for mCRC. Various factors, including performance status, age, and tumor sidedness, can be used to guide treatment selection. Biomarkers, such as RAS, BRAF, and microsatellite instability, can be useful for treatment stratification. Management of adverse events, to maintain quality of life, is a key consideration and is crucial to best practice in this setting. Common toxicities associated with third-line treatments are hand-foot skin reaction, fatigue, diarrhea, and cytopenias. Patients who receive third-line and later-line treatments should be monitored for these events, especially during the first 2 cycles. Dose modifications can also be used to manage toxicities and to minimize the effect on quality of life, while maximizing treatment benefit. Clinical trials of emerging agents, new treatment combinations, and novel therapies continue the efforts to improve outcomes for patients with mCRC. Sharing expert opinions on best practice for treatment selection and management can ultimately improve outcomes for patients with mCRC.
AB - An increasing number of patients with metastatic colorectal cancer (mCRC) are able to receive 3 or more lines of therapy. Treatments in this setting can include regorafenib (an oral multikinase inhibitor), trifluridine/tipiracil hydrochloride (TAS-102), antibodies that target epidermal growth factor receptor for patients with RAS wild-type tumors (if no prior exposure), and, where approved, anti-programmed cell death protein 1 inhibitors for patients with microsatellite instability-high mCRC. Although guidelines describe the available treatment options, few insights are provided to guide selection and sequencing. In this article, we share expert opinion from diverse geographic regions, to offer guidance for best practice when selecting and managing third-line treatment for mCRC. Various factors, including performance status, age, and tumor sidedness, can be used to guide treatment selection. Biomarkers, such as RAS, BRAF, and microsatellite instability, can be useful for treatment stratification. Management of adverse events, to maintain quality of life, is a key consideration and is crucial to best practice in this setting. Common toxicities associated with third-line treatments are hand-foot skin reaction, fatigue, diarrhea, and cytopenias. Patients who receive third-line and later-line treatments should be monitored for these events, especially during the first 2 cycles. Dose modifications can also be used to manage toxicities and to minimize the effect on quality of life, while maximizing treatment benefit. Clinical trials of emerging agents, new treatment combinations, and novel therapies continue the efforts to improve outcomes for patients with mCRC. Sharing expert opinions on best practice for treatment selection and management can ultimately improve outcomes for patients with mCRC.
KW - Patient selection
KW - Regorafenib
KW - TAS-102
KW - Treatment management
KW - Trifluridine/tipiracil
UR - http://www.scopus.com/inward/record.url?scp=85059154364&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059154364&partnerID=8YFLogxK
U2 - 10.1016/j.clcc.2018.11.002
DO - 10.1016/j.clcc.2018.11.002
M3 - Review article
C2 - 30598357
AN - SCOPUS:85059154364
VL - 18
SP - e117-e129
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
SN - 1533-0028
IS - 1
ER -